Severe acute respiratory syndrome bears an eerie resemblance to the Spanish flu pandemic that ravaged the world in 1918-19.

SARS is spreading like wildfire, striking about 20 nations since first appearing in China's Guangdong Province on Nov. 16.

Its flu-like symptoms, accompanied by fevers of 100 degrees or higher, pneumonia or pneumonia-like symptoms, breathing difficulties coughing and shortness of breath, are about identical to those seen in the WWI-era pandemic.

The nature of the disease baffles health officials today, just as the Spanish flu disorder did back in 1918.

No universally effective remedy has been found for SARS, just as none was found in the last pandemic.

Health officials believe the strain of the flu-like virus is a mutation of known viruses, which was the case with the Spanish flu. At least 103 people have died worldwide from SARS, and 2,750 have been infected, nearly half of them in China.

Unlike SARS, which first surfaced in China, the 1918-19 health disaster began in the United States.

The influenza pandemic of 1918-1919 killed more people than World War I - somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four years of the Black Death bubonic plague from 1347 to 1351. Known as Spanish flu or "la grippe," the influenza of 1918-1919 was a global disaster.

Here's how it began at Fort Reilly, Kans., Monday, March 11, 1918:

It was still dark when Mess Sgt. Albert Gitchell woke up. He felt terrible, and the thought of making breakfast for hundreds of hungry soldiers at Fort Reilly's Camp Funston in the predawn hours made him feel even worse.

He hadn't slept well. He'd gone to bed feeling miserable. He thought he was coming down with a cold and hoped a good night's sleep would make him feel better. It hadn't. After a night of tossing and turning, he felt worse than he had the night before.

His head throbbed, he was burning with fever, he had the mother of all sore throats and every muscle in his body ached.

He wouldn't be cooking breakfast for anybody this Monday morning, Gitchell thought, as he struggled out of his bunk and put on his fatigues. His tortured muscles protested every movement. His head pounded every time he took a step. He felt as if he hadn't slept in a week, and his body was on fire.

Without stopping to shave or shower, he left his barracks on this damp cold March morning headed for the camp hospital  and walked into the pages of medical history.

At Hospital Building 91, part of a sprawling Army medical complex that predated the Spanish-American War, the duty sergeant took Gitchell's temperature, noted it was 103 degrees, listened to the cook describe his symptoms and, as a precaution, ordered him to bed in the ward reserved for men suffering from any ailment that might prove contagious.

With Gitchell out of the way, the medic turned his attention to Cpl. Lee W. Drake, the next man in line. Drake, a truck driver assigned to the Headquarters Transportation Detachment's First Battalion, reported the same symptoms Gitchell described. The duty medic sent him to the same ward.

Right behind Drake came Sgt. Adolph Hurby. He was coughing, and his temperature was sky-high. His complaints echoed those of the two previous soldiers. His temperature hovered around 104 degrees, his pulse was low, he was drowsy, and he winced with pain every time his eyes were exposed to bright light. His throat, nasal passages and bronchial tubes were inflamed and badly congested with mucous. He was one sick soldier.

The medic was alarmed. Three men with identical symptoms arriving at the hospital within minutes of each other spelled trouble on any military base. But on a base packed with 26,000 men it could mean disaster. The last thing anyone on this huge Army base wanted in these waning days of World War I was an outbreak of contagious disease, and here was a clear warning that something very unpleasant might be loose and rapidly spreading.

It was more than the harried medic could deal with. He picked up the phone and alerted Lt. Elizabeth Harding, the chief nurse.

Within minutes Harding arrived at the building, one of a series of aging limestone structures with a combined capacity of 3,068 beds. She was immediately confronted with two more soldiers with symptoms matching Gitchell's.

Harding wasted no time. She grabbed the wall phone and called her commanding officer, Col. Edward R. Schreiner, a 45-year-old Army surgeon, rousing the sleeping doctor from his bed.

Schreiner listened to Harding with growing alarm. He had been dreading an outbreak of infectious disease at the overcrowded base, and what he was hearing from Harding sounded ominous.

He put the phone down, jumped out of bed, dressed hurriedly, and raced to the hospital in the sidecar of a motorcycle driven by his orderly.

Within minutes he saw his worst nightmares coming true. Soldiers were arriving in droves, all of them suffering from what he recognized as some form of flu that appeared to be highly contagious.

By noon, the list of men stricken with the mysterious illness had grown to 107. Before the week was over, 522 men had been felled by it.

Albert Gitchell, Army cook, had served as the advance guard for one of the deadliest epidemics in recorded history.

The Spanish influenza had made its 20th-century debut.

In a mere eight months it would kill between 20 million and 40 million people worldwide. In the United States alone, it would hit 20 million Americans, and kill a staggering 675,000 Americans, as many as died on both sides in the Civil War.

It would sweep across continents, leap over vast oceans, ravage whole villages, wiping out every single inhabitant in some of them. In the U.S., few families escaped its fury. Steadily mutating into more deadly forms as it spread, it would reach its zenith in October, killing with a fury that outmatched the worst of the war's carnage.

During the first week of November, it would kill 14,000 Londoners. Then, a week later, the war was over. And along with it, the worst of the epidemic.

History is filled with epidemics and plagues, outbreaks of disease that sweep across nations and continents leaving hordes of dead in their wake and then vanish as quickly as they appeared.

The more exotic are the best remembered - bubonic plague, smallpox, cholera, typhus, polio, and the latest scourge, Ebola Zaire  mainly because they are exotic.

Influenza, the flu virus, seems commonplace and less frightening than something as horrific as Ebola. The flu bug hits everybody at one time or another. And some winters, mini-epidemics cut a wide swath across whole areas of the nation.

We get it, we suffer its symptoms, sometimes for no more than a day or two, and then we recover.

It seems just too prosaic to qualify as a menace.

But in its more robust forms, it's a killer, as deadly as anything lurking in the swamps and jungles of equatorial Africa, and far more contagious.

The Spanish influenza (the word means influence in Spanish) is one of the lethal flu viruses. Its appearance in 1918 was a rerun. It has appeared and disappeared throughout recorded history under other names, or under no names at all. And every hundred years or so it has swept through large areas of the world, leaving piles of corpses behind, and the world's population markedly depleted.

More than 400 years before the birth of Christ, Hippocrates described an epidemic of a disease strikingly similar in its symptoms to the 1918 influenza strain. He wrote that it slaughtered an entire Athenian army.

In 1852, Dr. Theophilus Thompson, a London physician, noted that the deadly variety of flu virus never seems far away. "Influenza," he wrote, "does not, like the plague, desert for ages a country that which it has once afflicted."

Time and again the common flu bug has proven that it is capable of mutating into more violent forms. The bugs we're most familiar with those that make us miserable for brief periods  are perfectly capable of turning into wildly contagious homicidal monsters. And that's what makes them far more frightening than the more exotic forms of contagion.

Coming seemingly out of nowhere, they can emerge as full-blown epidemics, do their deadly worst, and then go into hiding, sometimes for a century or more.

In the 1950s, the director of the World Influenza Center in London, Dr. Andrewes, said: "I believe that the virus goes underground and perhaps does so all over the world ..."

It is, he warned, still possible that a pandemic could return at any time "and kill its millions as happened in 1918-19."

Added Australian microbiologist Sir Frank Burnet: "Of all the virus diseases, influenza is probably that in which mutational changes in the virus are of greatest human importance. We can only guess what type of virus was responsible in 1918-19 and what changes took place during the pandemic."

Burnet noted that since the human flu virus was first isolated in 1933 and two strains, Influenza A and Influenza B identified, both have undergone striking changes in makeup.

"Some of us believe that the influenza virus chief means of survival is its constant mutation to new serological patterns ..." he wrote.

In five weeks it hit 1,127 soldiers at Fort Reilly. It killed a mere 46 of its victims and then seemed to burn itself out.

But it wasn't finished. It was just lying low. It next struck in early May, ravaging soldiers in two divisions that had just arrived in Europe from Fort Reilly. In a matter of days it had spread to AEF Headquarters and in a mere 12 days infected 132 soldiers stationed there. By July it was rampaging across the globe, slowly mutating into a more lethal form and killing more and more of its victims.

By October it had become a homicidal maniac, butchering its victims by the millions in every corner of the globe.

And then it gradually crept away and went into seclusion, waiting patiently for its next opportunity to kill a few million people.

In 1960, a virus similar to the 1918 Spanish flu made a brief appearance in Canada, perhaps to remind us that it's still out there, waiting patiently for another Albert Gitchell to come along.

If we're lucky, the first victim of the SARS outbreak in China wasn't the new Gitchell.

Be careful about reading health books. You may die of a misprint. - Mark Twain (1835 - 1910)

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